Why Is 90 Days Needed for Addiction and Alcoholism Treatment?

Having a loved one attend treatment for 90 days provides adequate time for the family to receive support. It provides more time for involvement in family therapy, and time for adjustment to a new family dynamic.

One common question people have once they learn of a loved one’s need for addiction treatment is, “How long will they need treatment?” One of the simpler answers is “It depends.” But experts agree that the longer stays of a treatment seems to be more effective in long term recovery, as it helps the person with substance abuse disorder develop resources that may prevent relapse.

Research shows that it is difficult for many patients to stay in treatment. Some people are at higher risk for early abandonment of treatment, such as those who are younger, have a personality disorder, and those with cognitive deficits1.  Unfortunately, on average, only about 47 percent  of people maintain a year of sobriety after treatment.2 One way this success rate can improve is by ensuring at least 90 days of treatment are followed.

The National Institute on Drug Abuse (NIDA) reports, “research has shown unequivocally that good outcomes are contingent on adequate lengths of treatment. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited or no effectiveness, and treatments lasting significantly longer often are indicated.3

The NIDA’s statement  is similar to other study findings (see additional references below.)

Why 90 Days?

Research generally shows that anything less than 90-days is of limited effectiveness because it takes the brain up to 120 days  – or sometimes longer than one year – to return to its baseline functioning depending upon the substances used and intensity/duration of used10.  

Having a loved one attend treatment for 90 days will also provide adequate time for the family to receive support. It provides more time for involvement in family therapy, and time for adjustment to a new family dynamic. Addiction affects the entire family, not just the addicted individual15.  

Moreover, a 90-day treatment stay typically offers time for the facility to provide community reintegration services, which significantly improves chances of maintaining sobriety16.  

Helping people recover from addiction is not simply about stopping drug and alcohol abuse, it is about a much broader change. The goal is to help the addicted individual learn how to develop a lifestyle of wellness. This means developing healthier relationships, repairing damaged relationships, reintegrating into the workforce or returning to school, developing a fitness lifestyle, developing a healthier diet, a more reasonable weekly schedule, coping skills, and more.

Change is not easy, and it takes time. The science indicates that a longer treatment stay with more intensive treatment is most effective.

References and Resources for Further Reading

  1. Brorson, H. H., Arnevik, E. A., Rand-Hendriksen, K., & Duckert, F. (2013). Drop-out from addiction treatment: A systematic review of risk factors. Clinical Psychology Review, 33(8), 1010-1024.
  2. Dennis, M. L., Scott, C. K., Funk, R., & Foss, M. A. (2005). The duration and correlates of addiction and treatment careers. Journal of substance abuse treatment, 28(2), S51-S62
  3. https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/6-duration-treatment,
  4. Zhang, Z., Friedmann, P. D., & Gerstein, D. R. (2003).  Does retention matter? Treatment duration and improvement in drug use. Addiction, 98(5), 673-684.
  5. Moos, R. H., & Moos, B. S. (2003). Long‐term influence of duration and intensity of treatment on previously untreated individuals with alcohol use disorders. Addiction, 98(3), 325-338.
  6. Gossop, M., Stewart, D., & Marsden, J. (2006). Effectiveness of drug and alcohol counselling during methadone treatment: content, frequency, and duration of counselling and association with substance use outcomes. Addiction, 101(3), 404-412.
  7. Brecht, M. L., & Herbeck, D. (2014). Time to relapse following treatment for methamphetamine use: a long-term perspective on patterns and predictors. Drug and alcohol dependence, 139, 18-25.
  8. Reif, S., George, P., Braude, L., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Residential treatment for individuals with substance use disorders: assessing the evidence. Psychiatric Services, 65(3), 301-312
  9. Tanner-Smith, E. E., Wilson, S. J., & Lipsey, M. W. (2013). The comparative effectiveness of outpatient treatment for adolescent substance abuse: A meta-analysis. Journal of Substance Abuse Treatment, 44(2), 145-158.
  10. Bonnet, U., & Preuss, U. W. (2017). The cannabis withdrawal syndrome: current insights. Substance Abuse and Rehabilitation, 8, 9–37. http://doi.org/10.2147/SAR.S109576
  11. Heilig, M., Egli, M., Crabbe, J., Becker,H.. (2010) Acute withdrawal, protracted abstinence and negative effect in alcohol. Addictive Biology,15(2), 169-84.
  12. https://www.psychologytoday.com/blog/some-assembly-required/201505/detoxing-after-detox-the-perils-post-acute-withdrawal
  13. http://www2.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS
  14. Ventura, A. S., & Bagley, S. M. (2017). To improve substance use disorder prevention, treatment and recovery: Engage the family. Journal of addiction medicine, 11(5), 339-341.
  15. Daily, J. (2012). Adolescent and young adult addiction: The pathological relationship to intoxication and the interpersonal neurobiology underpinnings.
  16. Ram, D., Whipple, C. R., & Jason, L. A. (2016). Family Dynamics May Influence an Individual’s Substance Use Abstinence Self-Efficacy. Journal of Addiction and Preventive Medicine, 2(1), 106. http://doi.org/10.19104/japm.2016.106
  17. Friedmann, P. D., Hendrickson, J. C., Gerstein, D. R., & Zhang, Z. (2004). The effect of matching comprehensive services to patients’ needs on drug use improvement in addiction treatment. Addiction, 99(8), 962-972.

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